title: Certain secondary antiepileptic drugs can rescue hippocampal injury following a critical growth period despite poor anticonvulsant activity and cognitive deficits.
abstract: Clinical and experimental studies have shown that many common secondary antiepileptic drugs (AEDs) are ineffective at blocking seizures in adulthood; however, some afford neuroprotection. In early development, certain AEDs cause apoptosis; however, it is unknown whether these drugs are neurotoxic to the juvenile brain following a developmentally regulated proapoptotic period and whether they alter the seizure threshold, seizure-induced neuronal vulnerability, and/or cognitive function. Lamotrigine (LTG), carbamazepine (CBZ), phenytoin (PHT), valproate (VPA), and topiramate (TPM) were systemically administered to rat pups for 7days beginning on postnatal (P) day 14 (P14), then half the animals were injected with kainate (KA) to trigger seizures, an age when the CA1 subregion becomes preferentially sensitive to status epilepticus. Histological outcome, seizure severity, and learning and memory were determined with an electroencephalograph (EEG), silver impregnation, and a water-maze swim task. None of the AEDs tested significantly attenuated behavioral or electrographic seizures. Phenytoin increased mortality, identifying a detrimental side effect of this drug. The other drugs (LTG, VPA, TPM, and CBZ) afforded different amounts of protection to the CA1 subregion but not to the CA3 subregion or extrahippocampal structures. With the exception of VPA, AED-treated animals lagged behind during swim task acquisition. All groups improved in the water-maze swim task over time, particularly on the last trials; however, the average escape latency was still impaired for TPM-treated animals and all AED+KA-treated groups. Thus, while certain AEDs demonstrated some neuroprotective effects, poor antiepileptic activity, memory impairment, and other deleterious side effects were observed with these drugs suggesting that the search for potentially more effective and tolerated agents is essential for improving clinical outcome in children and adolescents with epilepsy.
authors.affiliation: Seton Hall University, South Orange, NJ 07079, USA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Halbsgut
authors.forename: Eiris
authors.initials: E
authors.lastname: Fahim
authors.forename: Karnika
authors.initials: K
authors.lastname: Kapoor
authors.forename: Henry
authors.initials: H
authors.lastname: Hong
authors.forename: Linda K
authors.initials: LK
authors.lastname: Friedman
mesh_terms: D000367:Age Factors; D000818:Animals; D000831:Animals, Newborn; D000927:Anticonvulsants / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D001930:Brain Injuries / Q000188:drug therapy* / Q000473:pathology*; D002452:Cell Count; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D004195:Disease Models, Animal; D018690:Excitatory Amino Acid Agonists / Q000633:toxicity; D005260:Female; D006624:Hippocampus / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure; D006801:Humans; D007608:Kainic Acid / Q000633:toxicity; D008297:Male; D018782:Maze Learning / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D012640:Seizures / Q000139:chemically induced / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D018690:Excitatory Amino Acid Agonists; D007608:Kainic Acid
keywords: Antiepileptic drugs; Cognition; Development; Hippocampus; Injury; Seizures